Blog | General Issues

The Opioid Crisis: A Public Health Emergency

By Taylor Davis

Medical team working in ERWith an average of 150 Americans dying each day from drug overdoses — many of them opioid-related — President Trump declared the opioid epidemic to be a public health emergency in the fall of 2017. This was the result of a recommendation to declare an emergency from a commission appointed by the president to study the opioid crisis in July. Following this recommendation, the White House deliberated over what type of emergency should be declared, as there is no precedent for the opioid epidemic.1 Ultimately, the administration settled on a public health emergency, through which funds and resources can be allocated to expand treatment for and prevention of opioid addiction.

Given this recent declaration, it’s important to understand what a public health emergency is, how it plays out in the federal government and its potential impact on the American people.

Defining a Public Health Emergency

So what exactly is a public health emergency? According to the World Health Organization, it’s defined as “an occurrence or immediate threat of an illness or health condition, caused by bioterrorism, epidemic or pandemic disease, or (a) novel and highly fatal infectious agent or biological toxin, that poses a substantial risk of a significant number of human facilities or incidents or permanent or long-term disability.”2

Because of the number of people currently impacted by opioid addiction, the epidemic qualifies as a public health emergency. On a state level, this means a governor can suspend state regulations or change the functions of state agencies.2 On a national level, this means using federal funds and resources from various agencies to target at-risk populations as well as opioid addiction prevention.

How Does It Differ from a National Emergency?

The primary difference between a public health emergency and a national emergency is the funding sources. Under a national emergency, the Federal Emergency Management Agency (FEMA) provides funding for disaster relief and recovery efforts. FEMA funds are designed to aid short-term, isolated crises, such as a hurricane or flood, rather than longtime crises like the opioid epidemic and its widespread reach.

Under the Public Health Services Act, the secretary of the Department of Health and Human Services is authorized to permit the federal government to assist state and local governments, suspend or modify legal requirements and expend funds available to address the emergency.3 This financial support comes from a designated public health emergency fund, but in recent years, Congress has not allocated money for this fund in the budget. In fact, currently only $57,000 is available for this purpose.4

What Does This Mean for the Opioid Crisis?

Through this declaration, the federal government is taking proactive steps to address the opioid crisis. It will waive regulations, give states more flexibility in using federal funds and expand the use of telemedicine for treating opioid addiction, particularly in rural areas where access to traditional, in-person medical care is limited.4 Because opioid use is not easy to monitor in these areas, telemedicine allows patients to virtually see doctors who can regulate opioid treatment plans or provide pain-relief alternatives when appropriate.

Several grants will fund efforts to aid the opioid epidemic. Under the public health emergency, state governments will be allowed to temporarily shift their use of federal grant funds to target opioid addiction. Additionally, Dislocated Worker Grants from the Department of Labor will be used to help individuals who have been displaced by the health crisis or unable to secure employment due to addiction.4

The recent declaration supports the efforts of the Substance Abuse and Mental Health Services Administration (SAMHSA), which has awarded several grants in recent years to address the opioid epidemic. For example, in May, SAMHSA launched its Opioid State Targeted Response grant program to increase access to evidence-based treatment, address unmet treatment needs and reduce opioid overdose-related deaths through provision of prevention, treatment and recovery services.5

Next Steps

In order to continue aiding the opioid crisis, the White House has pledged to work with Congress to include the public health emergency fund in any end-of-year budget negotiations or budget deal. This will enable the federal government to provide the monetary resources to support opioid addiction treatment and prevention.1

Additionally, the US Department of Health and Human Services (HHS) and SAMHSA will continue to collaborate around an opioid strategy that will focus on improving access to treatment, as well as strengthening research, data and reporting around opioid addiction and pain management.5 With all of these efforts, the opioid epidemic will remain a top priority for various agencies across federal and state governments in 2018.


Sources:

1 Keith, Tamara. “In Opioid Crisis, Public Health Emergency Vs. National Emergency.” NPR, October 26, 2017.

2Definitions: emergencies.” World Health Organization, Accessed December 28, 2017.

3Public Health Service Act, Section 319: Public Health Emergencies.” Association of State and Territorial Health Officials, Accessed December 28, 2017.

4 Johnson, Jenna, and John Wagner. “Trump declares the opioid crisis a public health emergency.” The Washington Post, October 26, 2017.

5SAMHSA Reaffirms Efforts to Address the Public Health Emergency on the Opioid Crisis.” Substance Abuse and Mental Health Services Administration, October 26, 2017.